If you’ve been strength training for a while—or you coach women—you probably have some questions about creatine.

While creatine has gained popularity, especially with those trying to gain muscle and strength, some women might be nervous about taking it due to conflicting (and sometimes inaccurate) information.

They may have heard that creatine causes water retention and weight gain, or that it will damage the kidneys, or that it’s just something “gym bros” take.

So what’s the truth about creatine? Let’s find out.

What We’ll Cover

In this article, you’ll learn everything you need to know about creatine and women, to decide if it’s a supplement you want to include in your nutrition strategy.

TL;DR / Key Takeaway:

Creatine is safe for most people—and it can be a powerful tool for helping women increase muscle mass. It can also improve performance, recovery, and may even protect brain health.

Let’s break down the facts and clear up the myths!

What Is Creatine? 

Creatine is an amino acid derivative that you can get from eating meat.

Fun fact: You also already have creatine in your body! It appears in the form of creatine phosphate (PCr or phosphocreatine), and about 95% of that is in skeletal muscle. 

What Does Creatine Do?

We need creatine phosphate to produce energy, and this allows muscles to work harder and longer.

When you supplement creatine in the form of creatine monohydrate, it increases creatine phosphate stores in your muscles.

With more creatine phosphate, you will be able to:

• Lift a given weight more times and therefore build more muscle. 
• Do very high-intensity exercise for longer—for instance, you can sprint longer or do a few more bouts of sprints.

How Exactly Does Creatine Work?

Supplementing creatine increases the capacity of an energy system in your muscles, lets you lift weights for more reps, and do very-high intensity exercise for longer (e.g., sprinting).

It does this by increasing the stores of one of your body’s energy pathways: the phosphocreatine pathway.

Energy Pathways in the Body

For context, there are three energy pathways or systems that give your muscles the energy they need. These are:¹

1. Phosphocreatine. Also known as phosphagen or the PCr pathway or system. This system is very high-energy but very low-capacity: It supports short bursts of intense exercise. When you sprint or lift weights (for about 10–15 seconds or less) your muscles mostly use the PCr system.
2. Glycolysis. Also known as the glycolytic pathway or system. This system is fast, high-intensity, and has medium capacity. When you sprint or exercise at a high intensity for longer than about 10 seconds to two minutes, your muscles mostly use the glycolytic system.
3. Oxidative. Also known as the aerobic pathway or system. This system is slow and has a very large capacity. Most of everyday living is oxidative. Think: sleeping, leisurely walking, sitting at your desk, brushing your teeth, and so on. If you’re exercising for longer than two minutes, your muscles will mostly use the oxidative system.

More creatine means more phosphocreatine, which means you have a higher capacity to do very high-intensity exercise, such as sprinting, explosive jumping, squatting, and bench pressing.

So Does Creatine Build Muscle?

Creatine doesn’t build muscle directly. Instead, it helps you do more of the training that builds muscle.

(Although creatine does increase the water in muscle and may, therefore, has a small effect on muscle growth.)²

Rather, it’s mainly the extra reps you may be able to do with more phosphocreatine that help you gain muscle and strength.

Most of the desirable effects of creatine (such as increased muscle and decreased body fat) are linked to exercise.

So you can’t just take a creatine supplement and wait for the effects to kick in. (Too bad.)

Why Does Creatine Matter for Women?

Because women have less total muscle than men, they also have less stored creatine—around 70–80% of men’s.

Women also tend to eat less dietary creatine (e.g., beef, lamb, pork, or fish) than men.^3,4

For women, supplementing with creatine monohydrate supports strength or performance goals and more.^4–7

(Want to download a cheat sheet all about women and creatine? Click here to get it now.)

Is Creatine Safe? 

Yes, creatine is safe for most women to take.

That said, for women who are pregnant, breastfeeding, or have specific diseases, supplementing may not be the best idea.

If you (or your client) are interested in supplementing with creatine, discuss it with a registered dietitian, healthcare provider, or pharmacist to determine whether creatine is helpful and safe for your unique situation.

Creatine monohydrate is among the most well-studied and effective supplements, and it has a decades-long safety record.

Creatine is one of the most researched supplements in the fitness world, with tons of research over decades showing its safety.

Is Creatine a Steroid? 

No, creatine is not a steroid.

It’s made from amino acids, the building blocks of protein. Again, we already have creatine in our body, and you can get it normally from eating meat and fish. Our body can make creatine from three amino acids: arginine, glycine, and methionine. 

How is Creatine Different From Steroids?

Creatine increases the capacity for high-power energy through phosphocreatine stores in muscle cells (and neural cells).⁸ As a result, it can support muscle building and performance.

But creatine isn’t the same as anabolic-androgenic steroids—the steroids that we usually associate with getting bigger and stronger.

Creatine differs from anabolic-androgenic steroids in the following ways:

• Creatine doesn’t increase muscle protein synthesis, or the formation of new muscle proteins. Anabolic steroids, on the other hand, do increase muscle protein synthesis.
• Creatine is not categorized as a drug by the FDA. Steroids are drugs.
• Creatine is not a controlled substance. Steroids are controlled substances.
• Creatine is legally allowed by governing sports bodies. Steroid use is banned from sports competitions.

Will Creatine Harm My Kidneys or Liver? 

Creatine is not harmful to your kidneys or liver, though more studies are needed on those with kidney disease.^9–11

Creatine May Affect Kidney Function Tests

While there is no evidence that creatine harms the kidneys or liver,⁹ creatine supplementation does affect kidney function tests of blood creatinine levels and calculated glomerular filtration rate.

CreatINine—note those extra two letters—is a waste product from the breakdown of creatine and phosphocreatine.^8,12

When you take creatine, blood creatinine levels go up.^8,12

Since the glomerular filtration rate (how fast the kidneys filter wastes from the body) is calculated from blood creatinine levels, researchers originally thought this change in blood creatinine meant creatine was inhibiting kidney function.

But a recent meta-analysis of women taking creatine found that while blood creatinine levels are elevated, they fall within normal ranges.¹³

With that in mind, it’s probably still smart to let your healthcare provider know you’re supplementing with creatine (ditto if you’re eating a higher-protein diet and working out) so that your bloodwork can be appropriately interpreted.

If you have kidney issues where kidney function is closely monitored, you should speak with your healthcare provider before taking creatine, to be on the safe side.

As for liver function: Creatine supplementation is safe for liver function, and there is no evidence of harmful or adverse effects of supplementation on liver health in women.¹³

Is it Safe to Take Creatine While Pregnant or Breastfeeding? 

Always consult your healthcare provider before starting a new supplement or medication during pregnancy or while breastfeeding, including creatine.

There’s minimal research on creatine supplementation in pregnant women. (There are some studies done on rats, but rats aren’t humans).

Research suggests it’s safe and potentially beneficial since, during pregnancy, there’s a decrease in available creatine in the body.^4,14,15 But the evidence is mostly in animals and isn’t clear enough to firmly say for sure.

Will Creatine Make Me Bloated or Gain Weight? 

No, creatine does not cause bloating or weight gain in most women who take the recommended dose of 3–5 grams per day (see below).

But you may hear that creatine can cause water retention, making you feel bloated or gain weight. These side effects don’t seem to happen in women, but may happen in men at higher doses of 20 grams/day.^8,13

Will Creatine Make Me Bulky? 

Creatine doesn’t cause weight gain or muscle gain by itself.

Creatine supplementation, along with strength training and excess calories, will increase muscle mass at a slightly higher rate.

But this is a good example of why we need research on women: Weight gain was reported as a side effect of creatine in studies done on men—but not in studies done on women.¹³

Beyond Muscle: What Are the Benefits of Creatine for Women?

OK, so we know that creatine increases muscle mass and strength, and improves exercise performance if supplemented regularly over months or years.^16–18

New research suggests that creatine may also help many other health conditions ranging from diabetes to brain dysfunction.¹⁹

Other Potential Benefits of Creatine

Potential benefits of creatine supplementation beyond increased muscle mass, strength and performance may include:¹⁹

• Decreased risk of sarcopenia or age-related muscle loss, a key risk factor in indicator of mortality. This is related to how creatine improves muscle mass, and strength.^19–22
• Muscle preservation while restricting calories (e.g., when losing body fat).
• Enhanced recovery after injury and improving rehab outcomes.
• Potentially better glucose management in Type 2 diabetics.^23,24
• Better bone health in older adults, likely because it enables people to do more exercise.^22,25–28
• Potentially better cardiovascular health in older adults—possibly because it enables people to do more exercise.^25–27
• Cardiovascular protection during ischemic events that can lead to heart attacks.^19,29
• Improved sleep duration in women.³⁰
• Better brain health and cognitive processing. The preliminary evidence suggests that any positive brain effects of creatine are linked to a deficit in brain creatine, or when brain bioenergetics is compromised. These conditions can arise from acute stressors (e.g., sleep deprivation) or chronic conditions (e.g., aging, mild cognitive impairment, depression).^19,25,31,32
• Neuroprotection against concussion and spinal injury. In animals, creatine has been found to reduce the severity of concussions and spinal cord injury.^8,33,34

Speaking of those last points…

Does Creatine Help with Brain Health?

Creatine may support brain health, especially during times of acute and chronic stress, though results are preliminary at higher doses (5 grams twice a day).

Though about 95% of the body’s creatine phosphate is in skeletal muscle, some is also stored in the brain. Thus, supplementing creatine doesn’t just add more in the muscles; it can also boost the brain’s small stores of phosphocreatine.

Indeed, creatine can cross the blood-brain barrier, and creatine is actively taken up by different neural cells—namely, neurons and oligodendrocytes.³⁵

Research over the last two decades has suggested that creatine might support key aspects of cognitive function, such as:^32,36,37

• Improving memory and focus
• Improving emotional regulation
• Lowering the risk of anxiety and depression
• Lowering the risk of some types of neurodegeneration

Another helpful role for creatine may be in supporting the brain under stress, such as with concussion or sleep loss. During these periods, the brain’s bioenergetics are compromised and creatine supplementation may help.

For instance, during times of sleep deprivation, creatine supplementation has been found to improve cognition and memory.⁷ (More on this below—sleep loss is a common problem around menopause.)

Creatine also seems to help with chronic conditions like aging, depression, anxiety, and cognitive impairment.^{7,19,25,31,32}

Does Creatine Help with Menopause Symptoms?

Yes, creatine can help with some menopause-related issues, but not hot flushes.

Women who are somewhere in the menopause transition (i.e., perimenopausal or postmenopausal) may benefit from creatine more than younger women, since creatine can help address concerns that tend to be more pressing around menopause.

For example, creatine:^4,27

• Helps maintain muscle mass and strength (which we tend to lose with age).
• Promotes bone health.
• Reduces inflammation and oxidative stress, which is especially important as we age.

Reminder: To see these benefits, strength training is essential—creatine works when paired with exercise!

And, as we’ve learned, creatine may:^{4,7,10,36–38}

• Protect the brain.
• Improve cognitive function, helping with the dreaded menopausal “brain fog”.
• Reduce depression.

Unfortunately, creatine won’t stop hot flushes or night sweats, but it might help with the stress and sleep problems they cause.

Sleep loss and stress can affect how creatine works in your brain, but there’s some evidence that taking creatine can reverse those changes. Creatine could even help with memory and other brain functions affected by poor sleep.^39–41

Who Should Take Creatine?

Anyone can benefit from supplementing with creatine, though people eating a lot of red meat may not benefit as much because their creatine stores are likely already high.

There are a few groups that benefit more from creatine supplementation:

• Athletes. Creatine can improve performance, muscle strength, and power.^42,43
• Older adults (65+). Creatine helps reduce age-related muscle loss and strength.⁴⁴
• Vegetarians and vegans. Not consuming meat, fish, or poultry rich in creatine means lower creatine levels.⁴⁵
• People at risk of a concussion or brain injury, such as soccer, football and rugby players. Creatine may be neuroprotective against brain trauma.^31,32

How to Start Taking Creatine

You can start taking creatine at any time, and there’s no need to take a higher dose when you start taking it (aka loading).

General guidelines are:

• 3–5 grams of creatine monohydrate per day, every day.
• Don’t worry about what to take creatine with. There is limited evidence that taking creatine with or without specific things (e.g., caffeine or carbohydrates) has a significant effect on creatine absorption.
• Be consistent with your intake. Give it at least two months before evaluating the results.

What Should I Look For?

When buying creatine, look for creatine monohydrate.

This is the most heavily researched and most popular of all the different types of creatine available on the market, and it’s the type typically recommended for folks who want to start supplementing.

Creatine ethyl ester (CEE) is a popular alternative to creatine monohydrate, but research shows it doesn’t offer any extra benefits for muscle, strength, or body composition.^46,47 Plus, unlike creatine monohydrate, it doesn’t have decades of proven safety data behind it—so approach with caution.⁴⁷

Of course, before starting any supplement, talk to a dietitian, doctor, healthcare provider, or pharmacist to make sure it’s safe and a good fit for you.

The Bottom Line About Creatine

Creatine is a safe, well-researched supplement that helps muscles produce energy for short, high-intensity activities like lifting weights or sprinting.

By boosting your body’s natural creatine stores, it supports strength, performance, and recovery. While creatine doesn’t build muscle directly, it enables you to train harder, which leads to muscle and strength gains over time.

Women, who naturally have less creatine than men and often consume less dietary creatine, may benefit significantly from supplementation.

Beyond exercise, creatine offers additional health benefits, especially for women. These benefits make creatine particularly valuable during the menopause transition.

And, as always, check with your healthcare provider about whether creatine is an appropriate option for you.